For CACDI, the better a hospital or medical center can document HCCs, the higher the possible RAF scores and the higher the reimbursement. While similar to Diagnosis-Related Groups (DRGs), RAF scores apply in the ambulatory setting as well as the inpatient setting, and that’s the best place for ambulatory CDI to focus their efforts.

ChartWise’s RAF Calculator puts hospitals and medical centers in the best possible position to assess and maintain an accurate patient risk profile which is imperative in today’s healthcare environment for a multitude of reasons, including:

Using Risk Adjustment to drive reimbursement started with Medicare Advantage plans, and is showing up in an increasing number of insurance plans

Risk Adjustment models predict health care costs of patients

The RAF for a patient has been difficult to calculate, and not generally available in a timely fashion

Real-time availability of the patient’s RAF score turns it into a valuable means to measure the impact of CDI, both inpatient and ambulatory

“To date, CDI has focused on the inpatient population, using DRGs to determine reimbursement, and Severity of Illness (SOI) and Risk of Mortality (ROM) to identify how sick a patient is,” said Dr. Jon Elion, founder and CEO of ChartWise Medical Systems. “However, as the CDI industry begins to contemplate outpatient or ambulatory, different metrics are required. We cover both

ChartWise Announces New RAF Calculator at 2017 AHIMA Convention

inpatient and ambulatory—providing both the DRG weight and RAF scores. This is truly a game-changer in the industry.”

An algorithm for calculating all of the current nine CMS and all of the 30 HHS Risk Adjustment models

RAF calculations for patients not currently enrolled in a RAF-based payer plan

RAF scores available for display and analysis at each stage of the CDI workflow

Functionality designed for a meaningful assessment of chronic conditions, in addition to the acute conditions already addressed by CDI

The 2017 AHIMA Convention takes place October 7-11 at the Los Angeles Convention Center and ChartWise will be on hand demonstrating their new RAF Calculator technology—along with a variety of additional advanced features contained within the company’s ChartWise 2.0 CACDI software solation—at booth 922 for the duration of the event.

About ChartWise

ChartWise Medical Systems, Inc., based in Wakefield, RI, is a medical software firm and the developer of ChartWise 2.0, a web-based solution for Computer-Assisted Clinical Documentation Improvement. ChartWise 2.0’s clinical intelligence expertise assists physicians and clinical documentation specialists with increased efficiencies and completeness of documentation, queries and workflow. Developed by renowned physician Jon Elion, M.D., ChartWise 2.0 is the only documentation software that translates clinical language used by physicians into accurate diagnostic language required for documentation and reimbursement. ChartWise was recognized on the 2016 and 2017 Inc. 5000 List as one of America’s fastest-growing private companies, placing first among all Rhode Island-based businesses on the list each year. ChartWise was also selected as the 2015/2016 and 2017 KLAS Award Winner for the CDI Software category, and as a 2015 Red Herring Top 100 North America and Global 100 Winner. For more information, visit www.chartwisemed.com.